Shoe Care Product Order Form

     First Name: 
      Last Name: 

        Address: 
        Address: 
           City: 
 State/Province: 
Zip/Postal Code: 
        Country: 

          Phone: 
            Fax: 
 E-Mail Address: 
Payment Method: Check: Money Order

Please select item(s) you wish to order, then print two copies of this form, one to send
to us and other copy for your records. Mail completed order form with payment to:
Shoestring Exchange Shoe Repair
32 Fickett Street
South Portland, ME 04106

Tel: (207) 767-3558
If you have any questions please contact us.

Description Qty Cost
Shoe Shine Brush $10.00
Polish Applicator $3.50
Suede Brush $4.00
Leather Dye (4oz bottle) $5.00
Edge Dressing $5.00
Heel Cushions $4.00/pair
Insoles $6.00/pair
Shoelaces $1.50
Bootlaces $2.00/pair
Rawhide Laces $5.00/pair
Mink Oil $4.00
Saddle Soap $4.00
Leather Oil $4.00
Leather Balm $4.00
Athletic Shoe Cleaner $5.00
Leather Cleaner $5.00
Shoe Cream $2.50
Shoe Polish $2.50
Liquid Silicone $4.00
De-salter $4.00
Shine Cloths (2 per pack) $4.00
Shoe Horns (18") $4.00
Shoe Horns (24") $5.00
Professional Shoe Shine Kit $45.00
Men's Shoe Trees (Plastic) $6.00/pair
Men's Shoe Trees (Cedar) $18.00/pair
Women's Shoe Trees (Plastic) $5.00/pair
Women's Pumps or High Heel Shoe Trees $4.00/pair
Shoe Stretch (4oz bottle) $5.00
$8.00

Sub Total: $
(5% tax rate) Total Tax: $
Total Order: $
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